Gender equality is a key pathway to ensuring lasting poverty reduction and shared prosperity. Identifying the main gender gaps that a country faces, across different domains, better informs policy design.
... See More + To that effect, this report seeks to identify where progress has been achieved in increasing opportunities and outcomes for women and men in Mexico and where further policy action is required. It focuses on three areas that are critical for gender-equal access to opportunities: (a) endowments, such as health and education; (b) economic opportunities, such as access to labor, land, and financial markets; and (c) agency, including norms, representation, and freedom from violence (World Bank 2012). The report takes advantage of the existing literature as well as different sources of publicly available data for the country and aims to provide a panorama of the prevailing gender gaps and areas for work to close those gaps, covering a wide range of outcomes. As such, it seeks to serve as a guiding document for policy action and dialogue, further research, and public discussion. With respect to health, three issues stand out. First, teenage pregnancy is very high relative to Organization for Economic Co-operation and Development (OECD) countries and is especially frequent among poor, low-educated, and indigenous girls. Second, although maternal mortality rates have declined, they are still very high in some regions and among vulnerable population groups, including rural and indigenous women. Finally, the incidence of obesity is among the highest in the world, which is linked to high incidence of diabetes and diabetes-related deaths, particularly among women. When it comes to education, gender gaps in enrollment and attainment are still a concern in lagging regions, where women face an especially large risk of dropping out, largely because of teenage pregnancy. Tertiary education, although more common now than ever before, is still far from being available to all women. Moreover, Mexico is among the lowest-ranking performers in international standardized tests among OECD countries, with girls underperforming more than boys, especially beginning in upper-secondary school. Differences in learning are reflected in educational choices, as women and men are still segregated across fields of education and areas of specialization. Beyond human capital endowments, it is difficult to imagine that women can thrive without access to productive inputs, including physical and financial assets, particularly if they are the sole breadwinners. In 2018, 65 percent of women did not own a high-value asset.
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Nonfinancial defined contribution (NDC) pension schemes have been successfully implemented since the mid-1990s in a number of European countries.
... See More + The NDC approach features the lifelong contribution–benefit link of a financial defined contribution scheme, but is based on the pay-as-you-go format. An NDC approach implemented by the rulebook can manage the economic and demographic risks inherent to a pension scheme and by design creates financial sustainability. This paper offers a nontechnical introduction to NDC schemes, their basic elements and advantages over nonfinancial defined benefit schemes, the key technical frontiers of the approach, and the experiences of countries with NDC schemes.
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The main goals of reforming the Norwegian old-age pension system toward nonfinancial defined contributions (NDC) in 2011 were to improve long-run fiscal sustainability and labor supply incentives.
... See More + Maintaining much of the redistributive effects of the former public pension system was also an important concern. Econometric analyses reveal the 2011 reform’s significant effects on postponing retirement. Results from a dynamic microsimulation model show that the reform is expected to have substantial effects on old-age pension expenditures in the long run without any large negative distributional effects. Macroeconomic analyses indicate that the reform is likely to make a great fiscal impact in the long run, and higher employment plays an important role in this aspect.
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Starting from a reconstruction of the political context in which the Italian 1995 pension reform took shape, this paper reviews the essential features of the 1995 and post-1995 legislation and assesses its fundamental shortcomings.
... See More + A straightforward theoretical discussion highlights both the targets and the instruments representing the hallmark of the nonfinancial defined contribution (NDC) model. The contrast of such theoretical premises with the Italian legislation points out the persistent original mistakes together with the necessary remedies.
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It is desirable that pension reforms and legislated rules have the backing of thepopulation or at least are accepted by voters. With the objective of achieving “acceptance,”the Swedish Pensions Agency publishes an annual actuarial balance of the solvency of the whole public pension system and distributes to each participant information on his or her individual accumulated notional balance and funded accounts, movements during the year,and estimates of the projected individual future pension amount.
... See More + This paper describes the Swedish pension experience in communication with pension participants over the last decade, together with the main changes in information delivered to improve individuals’ pension knowledge and help them make more informed, better decisions on work, savings,and retirement.
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This paper defines a universal public pension scheme (UPPS) as a government mandated lifecycle longevity insurance scheme that transfers individual consumption from the working years to retirement.
... See More + It discusses the differences in four UPPS designs designated as either defined contribution (DC) or defined benefit (DB), and financial or nonfinancial. With individual DC accounts, the ball is in the individual’s court. The transparent link between contributions and retirement income is the enabler of efficiency that through marginal decisions to choose formal work over informal work or leisure and to postpone retirement marginally toward the end of the working life, supports affordability and sustainability for a chosen level of adequacy. Hence, UPPS-DC designs are found superior to UPPS-DB designs.
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This paper discusses the potential expansion of the role of the notional defined contribution (NDC) paradigm in the ongoing reforms of retirement provision in China.
... See More + It finds that mature age life expectancy is remarkably uniform among formal sector workers at the time of retirement, although greater heterogeneity does exist for Rural and Urban Residents Pension Scheme members. The implications of a stylized NDC structure are examined covering China’s major pension systems, calibrated to be actuarially neutral. Each system has a different contribution rate and retirement age, consistent with different life expectancies. A complementary social pension is also proposed. The paper concludes that an increased presence of the NDC paradigm has the potential to raise aggregate welfare.
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Sweden’s reform began with a published sketch in 1992 and developed into nonfinancial defined contribution (NDC) legislation in 1994. This paper discusses the underpinnings of the Swedish NDC scheme’s financial stability, factors influencing the adequacy of benefits, and its interplay with other components of the pension system: the public financial defined contribution scheme, the minimum pension guarantee, and the occupational schemes.
... See More + The paper also includes information on the December 2017 broad six-party political agreement on forthcoming legislation. It concludes with recommendations for additional improvements in the overall old-age pension system, based on the analysis of financial stability, adequacy, and differences in outcomes, and the interaction of the NDC scheme with the guarantee benefits and the occupational schemes.
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Nonfinancial defined contribution (NDC) schemes offer governments desirable properties in terms of efficiency, fairness, and financial sustainability and an opportunity to deflect the blame for pension cuts.
... See More + Yet adoptions of NDC schemes largely ground to a halt and several countries retreated from NDC implementation after legislation. Lack of support from powerful international actors is partly to blame, as is the perceived rigidity of NDC in reducing room for policy maneuver. Correct implementation requires substantial administrative capacity. Less demanding automatic stabilizing mechanisms undercut the appeal of NDC in the European Union. Thus, while being an important option for policy makers and a benchmark against which to measure alternative reforms, NDC is unlikely to become the dominant pension design choice anytime soon.
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Differences in life expectancy between high and low socioeconomic groups are often large and have widened in recent decades. In the United States, the differences may now be as large as ten to fourteen years.
... See More + These longevity gaps strongly affect the actuarial fairness and progressivity of many public pension systems, raising the question of possible policy reforms to address this issue. This paper reviews the empirical literature on the longevity differences across socioeconomic groups and their impacts on lifetime benefits, considers how these impacts depend on four different pay-as-you-go pension structures (calibrated on the US case), and discusses some policy options.
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This paper shows that as the educational composition in the fifty-five to sixty-four year-old age bracket improved between the mid-1990s and the mid-2010s, the effective retirement age rose rapidly in the Central and Eastern European region.
... See More + This increase was fast enough to keep life expectancies at the effective retirement age practically unchanged. In effect, the labor market absorbed all improvements in life expectancies in older working ages. The paper also shows that maintaining the current life expectancies at retirement over the next thirty years requires less effort in terms of further raising the effective retirement age than what the region achieved in this respect in the last fifteen years.
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This paper starts from the fact that women receive lower pensions than men on average, and considers policies to address that fact. Women typically have lower wages than men, a greater likelihood of part-time work and more career breaks, and thus generally a less complete contribution record.
... See More + In addition, pension age may be lower for women and annuities may be priced using separate life tables for women. The paper looks at three strategic ameliorative policy directions: policies intended to increase the size and duration of women’s earnings and hence improve their contribution records; policies to redirect resources within the pension system, including for survivors and after divorce; and ways of boosting women’s pensions with resources from outside the pension system.
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A positive relationship between lifetime income and life expectancy leads to a redistribution mechanism when the average cohort life expectancy is applied for annuity calculation.
... See More + Such a distortion puts into doubt the main features of the NDC (nonfinancial defined contribution) scheme and calls for alternative designs to compensate for the heterogeneity. This paper explores five key mechanisms of compensation: individualized annuities; individualized contribution rates; a two-tier contribution structure with socialized and individual rates; and two supplementary two-tier approaches to deal with the income distribution tails. Using unique American and British data, the analysis indicates that both individualized annuities and two-tier contribution schemes are feasible and effective and thus promising policy options. A de-pooling by gender will be required, however.
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This paper identifies and discusses four issues in creating annuities in (nonfinancial) defined contribution (NDC) schemes that are essential for systems’ financial stability and fair inter or intragenerational redistribution.
... See More + The first issue is the choice between incorporating the rate of return into the annuity or into the exogenous indexation. The second issue is in choosing a projection method for life expectancy that produces systematically unbiased estimates. The third issue is at what age the projection of life expectancy is to be fixed over the remaining lifetime of the annuity. The final issue is the prevalence of socioeconomic heterogeneity within the insurance pool.
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Defined contribution (DC) schemes whether unfunded or funded are often considered superior to defined benefit (DB) schemes in their ability to address labor market issues, particularly in encouraging formal employment and delayed retirement.
... See More + Conceptually, the assessment is based on superior incentives to work and save. Yet economic and social realities are more complex. This paper explores design and labor market conditions that potentially constrain DC schemes. The paper concludes that to achieve their conceptual potential, DC schemes require design innovations, including a better integration of basic provisions and complementary labor policies that promote job creation in the formal sector and expand job opportunities during old age.
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This report recommends that China maintain the goal and direction of its healthcare reform, and continue the shift from its current hospital-centric model that rewards volume and sales, to one that is centered on primary care, focused on improving the quality of basic health services, and delivers high-quality, cost-effective health services.
... See More + With twenty commissioned background studies, more than thirty case studies, visits to twenty one provinces in China, the report proposes practical, concrete steps toward a value-based integrated service model of healthcare financing and delivery, including: 1) Creating a new model of people-centered quality integrated health care that strengthens primary care as the core of the health system; 2) Continuously improve health care quality, establish an effective coordination mechanism, and actively engage all stakeholders and professional bodies to oversee improvements in quality and performance; 3) Empowering patients with knowledge and understanding of health services, so that there is more trust in the system and patients are actively engaged in their healthcare decisions; 4) Reforming public hospitals, so that they focus on complicated cases and delegate routine care to primary-care providers; 5) Changing incentives for providers, so they are rewarded for good patient health outcomes instead of the number of medical procedures used or drugs sold; 6) Boosting the status of the health workforce, especially primary-care providers, so they are better paid and supported to ensure a competent health workforce aligned with the new delivery system; 7) Allowing qualified private health providers to deliver cost-effective services and compete on a level playing field with the public sector, with the right regulatory oversight; and 8) Prioritizing public investments according to the burden of disease, where people live, and the kind of care people need on a daily basis.
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Do service providers respond to pecuniary incentives to serve the poor? Service delivery to the poor is complicated by the extra effort required to deliver services to them and the intrinsic incentives of service providers to exert this effort.
... See More + Incentive schemes typically fail to account for these complications. A lab-in-the-field experiment with nearly 400 health workers in rural Burkina Faso provides strong evidence that the interaction of effort costs, ability, and intrinsic and extrinsic incentives significantly influences service delivery to the poor. Health workers reviewed video vignettes of medical cases involving poor and nonpoor patients under a variety of bonus schemes. Bonuses to serve the poor have less impact on effort than bonuses to serve the nonpoor; health workers who receive equal bonuses to serve poor and nonpoor patients see fewer poor patients than workers who receive only a flat salary; and bonuses operate largely through their influence on the behavior of pro-poor workers. The paper also presents novel evidence on the selection effects of contract type: pro-poor workers prefer the flat salary contract to the variable salary contract.
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The selected blogs were posted over the 2011-2018 period at World Bank Group sites, mostly in the Health, Nutrition and Population Global Practice (HNP GP) Investing in Health site.
... See More + The opinion article that is included was published in 2005, and the briefs over the 2000-2011 period. Patricio V. Marquez, Lead Public Health Specialist, HNP GP, and Coordinator of the World Bank Group Global Tobacco Control Program, and the World Bank Group Global Mental Health Initiative, is the lead author of most of the blogs, OpEd, and briefs, and was responsible for putting together this collection.
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Tobacco use is a significant hurdle to development gains worldwide. It is the leading cause of preventable death. Smoking-related illness costs billions of dollars each year, imposing a heavy economic toll on countries, both in terms of direct medical care for adults and lost productivity.In spite of these achievements, much more needs to be done to control this health scourge.
... See More + Raising tobacco taxes to make these deadly products unaffordable is the most cost-effective measure to reduce tobacco use or to prevent its initiation among youth. The benefits of higher tobacco taxes and prices are obvious, as there are good health outcomes both for individuals and entire communities that result from reduced consumption of tobacco products.This fiscal measure also helps expand a country’s tax base to mobilize additional revenue to fund vital health programmes and other essential public services.Looking ahead, increased tobacco taxation could represent an important revenue stream for helping finance the UN’s Sustainable Development Goals (SDGs) across the world.Tobacco control is fully aligned with the World Bank Group’s twin goals of ending extreme poverty by 2030, and boosting shared prosperity by increasing the income of the bottom 40 percent of the world’s population. It makes solid economic sense,given the high costs of tobacco-related ill health and premature death and disability of adults in their most productive years. Tobacco use also disproportionately affects the poorest people. More than 80 percent of the world’s smokers live in low- and middle income countries, harming health, incomes, earning potential, labour productivity, and undermining human capital accumulation– a critical factor for sustainable economic growth and social development.The World Bank’s Economics of Tobacco Toolkit helps researchers analyse the economics of tobacco policies in their countries, while other reports on the challenge posed by noncommunicable diseases in numerous regions and countries highlight the importance of tobacco control as a priority public policy intervention. World Bank teams, working with in country,regional and global partners, have provided technical assistance to design and implement tobacco taxation reforms intended to reduce tobacco use by raising prices for these products.The World Bank is committed to support the implementation of the global tobacco control effort outlined in this report,particularly tobacco taxation. Effective tobacco tax regimens that make tobacco products unaffordable represent a 21st century intervention to tackle the growing burden of noncommunicable diseases.
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Governments of developing countries typically spend between 20 and 30 percent of gross domestic product. Hence, small changes in the efficiency of public spending could have a major impact on aggregate productivity growth and gross domestic product levels.
... See More + Therefore, measuring efficiency and comparing input-output combinations of different decision-making units becomes a central challenge. This paper gauges efficiency as the distance between observed input-output combinations and an efficiency frontier estimated by means of the Free Disposal Hull and Data Envelopment Analysis techniques. Input-inefficiency (excess input consumption to achieve a level of output) and output-inefficiency (output shortfall for a given level of inputs) are scored in a sample of 175 countries using data from 2006-16 on education, health, and infrastructure. The paper verifies empirical regularities of the cross-country variation in efficiency, showing a negative association between efficiency and spending levels and the ratio of public-to-private financing of the service provision. Other variables, such as inequality, urbanization, and aid dependency, show mixed results. The efficiency of capital spending is correlated with the quality of governance indicators, especially regulatory quality (positively) and perception of corruption (negatively). Although no causality may be inferred from this exercise, it points at different factors to understand why some countries might need more resources than others to achieve similar education, health, and infrastructure outcomes.
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